COVER STORY OF THE MONTH
DIGITAL HEALTH – HEALTHCARE OF THE FUTURE
A recent study by PwC found that the Indian healthcare delivery system needs to add 3.6 million beds, 3 million doctors and 6 million nurses over the next 20 years. There are only 0.65 doctors, 1.3 nurses and 1.3 hospital beds per 1000 people in this country. This issue doesn’t seem unique of India, but is more global in nature. Consider NHS which has reportedly hired over 3000 foreign trained doctors in one year to plug shortage – these doctors come from 27 countries including India, Poland, Greece and also Iraq, Syria and Sudan for example. Another report states that of the 260k plus doctors registered with the GMC as of January 2015, 36.6% were foreign trained. China for instance has only 1.5 doctors per 1000 citizens. In addition to a catastrophic shortage of doctors, the healthcare management sector is impaired with other issues such as chaotic patient data, underfunded or lack of rural health centers and overburdened city hospitals. Add to this the high disease rates and lack of awareness on nutrition, and the problem only looks more deep-rooted.
A traditional and linear approach to addressing this problem is by building more hospitals at lower costs. It also means that we start churning out more doctors. However on their own, these approaches will probably not solve the problem. These need to be combined with alternative healthcare delivery by leveraging digital technologies. Consider this – in the last one year, access to internet has gone up from 35% to 42% of the world’s population, one-third of all the web pages now serve the mobile platform (72% in India), close to 40% of all global mobile connections are now classified as “broadband” (3G or 4G) and unique mobile users exceed 50% of the world’s population. Digital health using mobile communication systems can be used to provide a much wider access to healthcare information and resources to even remote locations. The whole mechanism of healthcare delivery will see a completely new turnaround by leveraging technology.
Telemedicine allows access to medical expertise when and where it is needed. With telemedicine, specialists can use live video conferencing for consultations, images from medical devices can be shared on a real time basis and smart devices equipped with sensors can transmit vital data to the specialist to support in diagnosis. Where real time consultation is not required, a store and forward approach enables patient data to be stored at a central location, and made available to the specialist for diagnosis at a convenient time. Her/ His opinion is then transmitted back to the base location. All the data could be stored on the cloud and support in the creation of an electronic medical record for the patient. The treatment is usually delivered locally. Mobile health clinics can leverage telemedicine to consult a specialist on need basis. Technology in this form can be highly leveraged to not only prescribe treatment but also for preventive care and early diagnosis. Tele-health solutions can also be used to provide remote training for healthcare professionals that in turns equips them to provide care in rural locations.
Using Remote Patient Monitoring (RPM), patient biometric data and their health status can be collected, tracked and transmitted from a patient’s home or remote location to a healthcare provider. Using RPM, patients can actively engage and take more ownership for their own care and avoid un-necessary hospital admissions or visits. The healthcare provider can monitor patients after discharge, using RPM thereby allowing their beds to be prioritized for critical cases.
In a healthcare unit, an IOT (Internet of Things) enabled medical device can provide daily utilization statistics that can be leveraged for patient scheduling. Given that these machines are extremely expensive, information relating to the machine’s schedule will be critical to ensure optimal utilization. Based on this information for example, patients could be re-assigned to another MRI at another location that may be under-utilized. These machines can also automatically feed back to the “parent” when consumables require replenishment or when there is any fault deducted requiring repair.
The other trend that healthcare is now catching up on is consumerization, thanks to a more empowered set of consumers who have information, cost and quality data available to them thanks to technology. The new breed of more informed consumers are now taking more ownership for managing their health as opposed to just play the role of passive recipients. This will mean that the institutional stakeholders such as hospitals, pharmaceutical organizations, insurers and pharmacies will most definitely need a deeper understanding of consumer behavior and their interests to be able to provide more transparent and personalized experiences. This understanding itself will lead to possibilities of new business models that allows to cut costs and improve care.
Healthcare providers are likely to become more patient centric in every aspect of their performance delivering the highest levels of service akin to consumer friendly industries. Healthcare providers have access to immense amount of consumer data. They will do this by relying on rich insights resulting from intensive data analysis about their consumer preferences, their health status, their propensity to purchase specific products etc. They will leverage tools and applications that support better consumer engagement at the time of delivering care by incentivizing people who pursue healthy lifestyle, come up with healthcare bundles that allows the consumer to pick and choose based on their preference, provide simplified pricing and billing systems, streamlined admission processes, send treatment reminders, or suggest a lifestyle change. Mobile health and social media can be leveraged to spread awareness to engaging consumers to make healthier lifestyle choices. Using mobile, consumers can not only book appointments via their personalized website but also track it, receive reminders and monitor their prescriptions.
Despite the immense opportunities for leveraging digital technologies in healthcare, adoption still is at a slow pace due to significant barriers. Technologists and entrepreneurs require a deep understanding of this space to be able to offer solutions that cater to more deep rooted problems rather than just targeting low hanging fruits such as applications for booking doctor appointments or tools that track dietary intake. Also it is important to ensure that elements of risks and security are identified and a mitigation plan is put in place – examples of these could be security aspects relating to dealing with medical records of a customer, risks relating to faulty applications or risks as a result of network, device downtime etc. that may lead to time and information loss. There needs to be better participation from the ecosystem which includes not only providers, but importantly doctors, practitioners, pharmaceutical companies, insurers, pharmacies etc.
End of the day, the solution has to make sense to the end customer. The overall quality and cost of care should be compelling enough to make a business case for itself and attract audiences. This cannot come from any one technology or vendor. Rather there should be a confluence of approaches in collaboration with multiple players in the ecosystem including insurers, healthcare providers, pharmacies, pharmaceutical companies, technology players and device manufacturers to ensure more accessible and provide a cost effective model for the consumer.